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General NPI Number Information
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NPI Number | 1598683757
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Entity Type | Organization
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Legal Business Name | TC TOTS
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 900 SE OCEAN BLVD STE B115
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City | STUART
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State | FL
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Zip | 34994-2471
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Country | US
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Telephone | 772-618-6487
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Fax |
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Provider Business Mailing Address
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Address Line | 900 SE OCEAN BLVD STE B115
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City | STUART
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State | FL
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Zip | 34994-2471
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Country | US
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Telephone | 772-618-6487
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Fax |
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Authorized Official
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Title or Position | VP
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Name | DR. LUIS A MATOS
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Credential | DN 18887
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Telephone | 772-618-6487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 125Q00000X
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Taxonomy Name | Oral Medicine Dentistry
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License Number |
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License Number State |
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